Individual provider Active NPI

Laura Osborn Moody, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Memphis, TN
National Provider Identifier
1265433890
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD31880 Issued in TN
Practice address
3495 Hacks Cross Rd
Memphis, TN 38125-8803
Phone
(901) 526-7444
NPI assigned
Aug 4, 2005
Last updated
Feb 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD31880 TN Primary

Addresses

Primary practice location

3495 Hacks Cross Rd
Memphis, TN 38125-8803

Mailing address

3495 Hacks Cross Rd
Memphis, TN 38125-8803
Phone (901) 526-7444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100804000711 TN Practitioner - Pathology 4789717265 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD31880TNMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ameripath Indianapolis PC Anatomic Pathology & Clinical Pathology CurrentSince Sep 30, 2024 Accepting new patients
Ameripath Indianapolis PC Anatomic Pathology & Clinical Pathology CurrentSince Sep 30, 2024 Accepting new patients
Poplar Healthcare, PLLC CurrentSince Aug 1, 2000 Accepting new patients
Ameripath Indianapolis PC Current Accepting new patients

Locations

13179 Collections Ctr D
Chicago, IL 60693

150 Collins St
Memphis, TN 38112
Phone (901) 526-1912

660 Jefferson Ave
Memphis, TN 38105
Phone (901) 526-7444

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1265433890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 HACKS CROSS RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258803",
            "telephone_number": "901-526-7444",
            "fax_number": "901-526-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3495 HACKS CROSS RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258803",
            "telephone_number": "901-526-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "LAURA",
        "middle_name": "OSBORN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-04",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "MD31880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.